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Osteonecrosis of the jaws produced by sunitinib: a systematic review

C Vallina1, L Ramírez, J Torres

  • 1Departamento de Especialidades Clínicas Odontológicas, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal S/N 28040-Madrid, Spain, rmlopezp@ucm.es.

Medicina Oral, Patologia Oral Y Cirugia Bucal
|April 24, 2019
PubMed
Abstract

Insights

Sunitinib may increase the risk of osteonecrosis of the jaws (ONJ), particularly when used with other medications. Further research is needed to establish clear protocols for managing this side effect in cancer patients.

Area of Science:

  • Oncology
  • Oral and Maxillofacial Surgery
  • Pharmacology

Background:

  • Tyrosine kinase receptors are crucial in cancer progression, angiogenesis, and metastasis.
  • Sunitinib is a tyrosine kinase inhibitor used in cancer therapy.
  • The association between sunitinib and osteonecrosis of the jaws (ONJ) requires clarification.

Purpose of the Study:

  • To systematically review existing literature on ONJ in patients treated with sunitinib.
  • To identify potential risk factors associated with sunitinib-induced ONJ.

Main Methods:

  • A systematic literature search was conducted in PubMed/MEDLINE and Cochrane Library up to September 2018.
  • Included studies were observational, cross-sectional, and case reports/series involving human subjects.
  • Methodological quality was assessed using Joanna Briggs Institute and Newcastle-Ottawa tools.

Main Results:

  • 13 studies (7 case reports, 5 case series, 1 retrospective study) published between 2009-2018 were included.
  • Out of 102 patients treated with sunitinib, 58 developed ONJ.
  • ONJ occurred in patients treated with sunitinib alone or in combination with bisphosphonates or other antiresorptive drugs.

Conclusions:

  • Sunitinib use is associated with an increased risk of ONJ, even in patients not taking bisphosphonates or denosumab.
  • Healthcare professionals (dentists, surgeons, oncologists) must be aware of this ONJ risk.
  • Further research is essential to enhance understanding and develop management protocols for sunitinib-related ONJ.

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